Towards more nutrition-friendly food systems for the 21st Century
Why is it so difficult to make healthy diet choices? Is it really just an individual responsibility? For Lawrence Haddad the answer is no. He points out that policies, rather than individual choices, can help a big deal to shift from food systems to more nutrition friendly food systems
Each of us on this earth is served by a food system. How well are we being served? Current food systems have done a very impressive job of producing more food, but the numbers say 800 million people are still going to bed hungry every night and 1.9 billion are now overweight or obese. The former number is slowly decreasing while the latter is rapidly rising. In a world of 7 billion, that means nearly 40% of the world’s population is not served well at all by current food systems.
But isn’t this all about individual responsibility? Aren’t people just making poor choices? Clearly this is not the case for people who are hungry—they can’t afford to buy enough food to stave off hunger no matter what choices they make. They are failed by food systems that those living at the so called “bottom of the pyramid” cannot afford. But what about those who are not extremely poor, can’t they make the choices needed to purchase healthy diets? Unfortunately, making healthy food choices is hard. Highly processed foods are everywhere. And they tend to be high in sugar, fat and salt. They can be transported easily and have a long shelf life and so can be placed in front of many consumers. Their extensive processing also supports very large markups from farm ingredients to retail price. In addition they are designed to plug into the human desire for variety. Hence they are front and centre in multiple locations in our food environment: on TV, on the internet, on mobile phones, on public transport and at checkouts in supermarkets. Healthier foods tend to be less processed, store less easily and have lower markups. They cannot be easily branded or “varietised”. They aren’t as accessible. It can be difficult to get to locations that sell them. And when they are available they tend to be expensive. Food systems need to deliver food that is accessible, affordable, safe, and healthy. In other words, food systems need to deliver food security and nutrition.
So how do we move from food systems to more nutrition friendly food systems? Do we know what to do? We have some ideas. There is a reasonable evidence base on the kinds of policies that have a good chance of working. The policies aim to shape the production, productivity, marketing, labelling and accessibility of foods. The evidence base is not as strong as it is for undernutrition reduction, because so many of the food system interventions are policies rather than programmes, and policies are not easy to randomise. In addition, few policies have been implemented, and if they are not implemented they can’t be evaluated. For instance, of the 67 countries that have been documented as having implemented interventions to make food systems more nutrition friendly, hardly any are from low income locations, where obesity rates are not as high as middle and high income countries but where, without exception, they are rising (IFPRI 2015).
But even if we have a broad idea of what to do, how do we incentivise policymakers to implement them? Implementation means taking on vested interests. Businesses don’t like to be constrained or nudged as it disrupts the optimisation of profits, their primary goal. If businesses are affected negatively in the short term, jobs may be lost, tax revenues may go down and economic growth may suffer, with potential negative consequences for health. The tradeoffs are not straightforward, either technically (what will the direction and magnitudes be?) or politically (how can they be negotiated?).
This complexity is really challenging for policymakers and it makes policy research relevant and interesting. That is why I am so pleased to be chairing an initiative for the Global Panel on Agriculture and Food Systems for Nutrition to answer the question “What decisions do policy makers need to take in the coming decades to ensure that food systems deliver high quality diets that are accessible in low and middle income countries by 2035, particularly for women and children?”
We will release a report next summer which will help guide policymakers through the technical, policy and political pathways towards actions they can take to make their food systems more nutrition friendly. At the moment food systems serve the nutritional needs of only 6 out of 10 people on the planet. Based on current trends in urbanisation, globalisation and obesity, this number—already too low—will likely decline even further. But these numbers are not destiny. They are driven by choices. Policy choices need to be made to protect the diets of the most vulnerable. Our report will serve as a call to action and will make it harder for policymakers to ignore this issue and fail to act. After all, everyone deserves to be able to engage with a food system that serves their health and nutrition.